Malaria Prevention Strategies Research Articles

Perspectives of postpartum women on intermittent presumptive treatment in Uganda: implications for malaria prevention: a qualitative study.

Malaria during pregnancy leads to many deaths in Africa. COVID-19 contributed to more malaria cases due to interruptions in prevention efforts. Intermittent presumptive treatment (IPTP) is an effective malaria prevention strategy for pregnant women, but adoption barriers still exist. The study aim was to explore barriers to the adoption of IPTP at Kawempe National Referral Hospital (KNRH) Uganda. In a qualitative study design, data was collected using focus group discussions. A total of 37 postpartum mothers were interviewed in six focus group discussions. The interviews were conducted using a structured guide to explore barriers to IPTP implementation at KNRH. The data was transcribed, coded, and analysed using NVivo 10. The study found that mothers lacked adequate knowledge about IPTP, faced socioeconomic and cultural constraints, fear of side effects, a high pill burden, and experience of health system challenges as major themes of barriers to optimal IPTP use. Challenges in the service delivery and inadequate information in regard to importance and expected side effects were identified by the users as the major barriers to IPTP delivery in public health care setting. Improving delivery of focused health education talks and health work attitude and delivery chain for IPTP in the health facilities are recommended to increase its uptake.

Epidemiological characteristics of imported malaria after malaria elimination in Shanxi Province, 2019-2023

Objective: To analyze the epidemiological characteristics of imported malaria cases from 2019 to 2023 after the elimination of malaria in Shanxi Province, and provide reference for formulating scientific and effective malaria prevention and control strategies in Shanxi Province. Methods: The data of imported malaria cases were collected China Information System for Disease Control and Prevention and National Parasitic Disease Control Information Management System in Shanxi Province, from 2019-2023. Descriptive epidemiological method and SPSS 26.0 statistical software were used for descriptive epidemiological statistical analysis. Results: A total of 51 malaria cases were reported in Shanxi Province in 2019-2023, all imported from abroad. Among them, there were 38 cases of falciparum malaria (74.51%), 6 cases of plasmodium ovale (11.77%), 5 cases of plasmodium vivax (9.80%), 1 case of plasmodium triticum malaria (1.96%), and 1 case of mixed infections (1.96%), with nodeaths; cases were predominantly males (94.12%, 48/51) and workers who went abroad for work (84.31%,43/51); the median age of onset was 37 years old; and there were imported cases every month, with no obvious peak of incidence; Taiyuan City reported the most cases, accounting for 72.55% (37/51) of the total number of cases,the source of infection of cases was mainly from Africa (96.08%), with the Democratic Republic of the Congo (16 cases), Nigeria (6 cases), Equatorial Guinea (5 cases), Mozambique (3 cases), and Republic of the Congo (3 cases) in that order; the median time between the onset of disease and first diagnosis, and the median time between first diagnosis and confirmation, were two times longer than that of first diagnosis, and the median time between first diagnosis and confirmation was two times longer than that of first diagnosis. The M(Q1, Q3) intervals from onset to first diagnosis and from first diagnosis to confirmed diagnosis were 2(0,4) days and 1(0,3) days, respectively, with statistically significant differences between different years from onset to first diagnosis (H=17.41, P=0.048), and from first diagnosis to confirmed diagnosis (H=20.82, P=0.010). A total of 101 146 blood tests for febrile patients were conducted in the province during the five years, with the minimum number of blood tests in 2020 (19 867 person-times) and the maximum number of blood tests in 2023 (20 778 person-times). Conclusions: After the elimination of malaria in Shanxi Province from 2019 to 2023, all malaria cases were imported from abroad, and it is still necessary to strengthen the surveillance of people traveling to and from malaria-endemic areas, implement the combination of medical treatment and prevention, and jointly prevent and control the occurrence of imported malaria.

Efficacy of Malaria Symptoms as an Indicator of Malaria Infection among Students of a Tertiary Institution in Ogun State Nigeria

Malaria is a life-threatening disease caused by the parasite Plasmodium, which is transmitted through the bite of an infected female Anopheles mosquito. Asymptomatic Plasmodium falciparum parasitemia refers to the presence of the parasite in the absence of fever or malaria-related symptoms. In Ijebu-Igbo, Ogun State, Nigeria, a study was conducted to ascertain the frequency of asymptomatic malaria among students attending higher education institutions and determine the efficacy of malaria symptoms as an indicator of malaria infection. A total of 115 students who consented to participate in the study were enrolled, and only a total of 93 of the respondents were recruited for the study, having met the inclusion criteria. A structured questionnaire was used to obtain data on socio-demographic characteristics, signs and symptoms of malaria, and malaria prevention strategy using Insecticide Treated Nets (ITN). Blood samples were collected from the respondents and diagnosed for malaria using Rapid Diagnostic Tests (RDT) kit. Of the 93 respondents, 32 (34%) were males while 61 (66%) were females. Analysis of the result showed that 77% of the respondents had malaria parasites, 38.7% of the respondents indicated that they do feel feverish sometimes while 47.3% responded that they rarely feel feverish, those who rarely show symptoms were observed to be asymptomatic as the result of the RDT was positive for malaria. On the use of Insecticide Treated Net (ITN) for both categories of students, those who are not using the net had a higher prevalence (64.5%) of malaria infection. The result of this study shows that malaria symptoms is not a good diagnostic tool for determining treatment. Asymptomatic malaria was a risk factor among the students therefore measures to reduce the prevalence are advocated.

Malaria Prevention and Control in Nigeria: Evaluating the Effectiveness of Current Strategies

Malaria has been a significant public health challenge in Nigeria, contributing to high morbidity and mortality rates, particularly among children under five and pregnant women. Despite all efforts made to control and prevent malaria, Nigeria continued to bear a disproportionate share of the global malaria burden. This review critically evaluated the effectiveness of current malaria prevention and control strategies in Nigeria, including the use of insecticide-treated nets (ITNs), indoor residual spraying (IRS), chemoprevention, and public health education campaigns. The methodology involved a comprehensive analysis of peer-reviewed studies, government reports, and data from international health organizations to assess these strategies. The review identified gaps in the implementation of these strategies and explored innovative approaches that could enhance their impact. It also discussed the role of environmental management, community engagement, and the integration of technology in malaria control efforts. The findings suggested that while existing strategies have made significant progress in reducing malaria transmission, challenges such as resistance to insecticides, inconsistent use of preventive measures, and limited healthcare infrastructure hindered their overall effectiveness. The review concluded by proposing recommendations for strengthening malaria prevention and control efforts in Nigeria, with a focus on sustainability, scalability, and community involvement. Keywords: Malaria Control, Insecticide-Treated Nets (ITNs), Indoor Residual Spraying (IRS), Chemoprevention, Environmental Management.

Malaria Prevention Strategies in Kalimantan, Indonesia: A Secondary Analysis of 2018 Basic Health Research Data

Background: Kalimantan remains malaria-endemic, particularly in rural areas, where prevention efforts face challenges such as insecticide resistance and limited healthcare access. Despite available measures like insecticide-treated nets, gaps in understanding individual and household prevention practices persist, especially in relation to demographics and effectiveness in reducing malaria transmission.Purpose: This study aimed to examine the individual and household-level malaria prevention strategies utilized in rural Kalimantan and evaluate their effectiveness in reducing malaria incidence.Methods: The study is a secondary analysis of the 2018 Basic Health Research. A total of 67,155 respondents in Kalimantan were analyzed including respondent characteristics, memories of malaria infection, and individual and household malaria prevention efforts. Bivariate regression and multivariable logistic regression were used in data analysis.Results: Older participants were less likely to report having malaria, although self-reported malaria rates were higher among older respondents compared to younger ones. Women reported lower malaria rates than men, especially in South Kalimantan. Agricultural workers showed a higher likelihood of reporting malaria than the jobless, though not statistically significant. In West Kalimantan, the use of bed nets was associated with higher self-reported malaria rates (OR=1.838, 95% CI:1.147–2.943). Short-term use of Insecticide Treated Nets showed varying odds across provinces: Central Kalimantan (OR = 3.659, 95% CI 1.378–9.717), South Kalimantan (OR = 10.811, 95% CI 3.649–32.030), East Kalimantan (OR = 2.615, 95% CI 1.041–6.567), and West Kalimantan (OR = 2.428, 95% CI 1.446–4.078). In all provinces, preventive measures such as coils or electric mats reduced self-reported malaria cases. The use of mosquito screens was effective in South Kalimantan (OR = 0.208, 95% CI 0.027–1.598), Central Kalimantan (OR = 0.365, 95% CI 0.120–2.181), and North Kalimantan (OR = 0.000, 95% CI 0.000–0.000). The multivariate model highlighted mosquito nets as the most effective household-scale prevention in nearly all Kalimantan provinces, except North Kalimantan.Conclusion: This study shows that individuals aged 25 and over, women, non-farmers, and those using insecticide-treated nets (ITNs) and other preventive measures, especially in rural areas, were less likely to report malaria, emphasizing the need for targeted interventions from local health authorities

Overview of Malaria in Pregnancy: Challenges and Strategies for Effective Prevention

Malaria in pregnancy is a significant public health issue in sub-Saharan Africa, with 30 million pregnancies at risk each year. Pregnant women are particularly vulnerable due to immunological changes and the placental environment that facilitates parasite sequestration. The predominant malaria parasite, Plasmodium falciparum, is associated with significant maternal and fetal complications. Effective malaria prevention strategies include insecticide-treated nets (ITNs) and intermittent preventive treatment (IPTp) with Sulfadoxine-pyrimethamine. However, adherence to preventive chemotherapy is challenging due to side effects and socioeconomic barriers. Health education programs are crucial for increasing awareness and promoting preventive behaviors. Early diagnosis and prompt treatment are critical for managing severe malaria cases. Environmental and vector control measures, such as indoor residual spraying and larval source management, are vital for reducing mosquito populations and transmission. Nutritional interventions support immune function and overall health. Access to healthcare services, innovative technologies, and cultural and socioeconomic factors are essential for overcoming barriers to malaria prevention and treatment. Continuous monitoring and evaluation are crucial for refining interventions and improving health outcomes. Keywords: Malaria, Pregnancy, Challenges, Strategies, Effective Prevention

Immunogenic and diagnostic potential of recombinant apical membrane antigen-1 from Plasmodium malariae

The apical membrane antigen-1 (AMA-1) is a crucial target for malaria management and prevention strategies. While the immunogenicity of AMA-1 has been extensively studied for Plasmodium falciparum and Plasmodium vivax, there is a notable scarcity of information for Plasmodium malariae. In this study, recombinant PmAMA-1 was expressed in Escherichia coli, and its integrity was confirmed via western blotting and indirect immunofluorescence assays. Immunization of BALB/c mice with rPmAMA-1 emulsified in Freund's adjuvant resulted in significantly elevated specific IgG antibodies, predominantly IgG1. The immune response exhibited Th1, Th2, and Th17 phenotypes, with a notable Th1 bias. Antisera from immunized mice effectively recognized native PmAMA-1 on P. malariae. These results suggest that PmAMA-1 is a promising target for both vaccine development and diagnostic applications for P. malariae infections, offering dual preventive and diagnostic benefits in malaria control.

Epidemiological characteristics and strategies for prevention and elimination of malaria in Qingdao, Shandong Province, China from 1949 to 2021.

Malaria is an insect-borne disease transmitted by Anopheles mosquitoes or the importation of Plasmodium-infected blood, posing a serious threat to human health and life safety. This study aims to analyze the incidence of malaria in Qingdao at various stages from 1949 to 2021, to collate the control measures taken at different epidemic stages to assess the effectiveness of malaria control, and to identify a set of malaria control strategies suitable for Qingdao, while providing Chinese experience for other countries or cities in their malaria elimination efforts. A retrospective survey was used to collect information on malaria cases, control measures and prevention and control effects in Qingdao from 1949 to 2021, and to evaluate malaria control strategies and measures in Qingdao. 704 155 cases have been reported from 1949 to 2021, with three epidemic peaks: the incidence rate was 1715.9/100 000 in 1961, 1409.7/100 000 in 1965, and the most severe case occurred in 1972, with an incidence rate of 1635.6/100 000 and a case count exceeding 90 000. Throughout the various stages of malaria epidemics, Qingdao has effectively eliminated indigenous malaria by implementing diverse preventive and control measures. Since the last indigenous case of Plasmodium vivax was reported in 2002, all locally reported cases have been imported, mainly by returning migrant workers from Africa. This study examines a range of malaria prevention and control strategies and interventions that are appropriate for Qingdao. These measures have enabled Qingdao to successfully eliminate malaria and maintain malaria-free status for more than 20 years. These measures can also serve as a reference for similarly situated cities in Africa and Southeast Asia.

Tiny Green Army: Fighting Malaria with Plants and Nanotechnology.

Malaria poses a global threat to human health, with millions of cases and thousands of deaths each year, mainly affecting developing countries in tropical and subtropical regions. Malaria's causative agent is Plasmodium species, generally transmitted in the hematophagous act of female Anopheles sp. mosquitoes. The main approaches to fighting malaria are eliminating the parasite through drug treatments and preventing transmission with vector control. However, vector and parasite resistance to current strategies set a challenge. In response to the loss of drug efficacy and the environmental impact of pesticides, the focus shifted to the search for biocompatible products that could be antimalarial. Plant derivatives have a millennial application in traditional medicine, including the treatment of malaria, and show toxic effects towards the parasite and the mosquito, aside from being accessible and affordable. Its disadvantage lies in the type of administration because green chemical compounds rapidly degrade. The nanoformulation of these compounds can improve bioavailability, solubility, and efficacy. Thus, the nanotechnology-based development of plant products represents a relevant tool in the fight against malaria. We aim to review the effects of nanoparticles synthesized with plant extracts on Anopheles and Plasmodium while outlining the nanotechnology green synthesis and current malaria prevention strategies.

Evaluation of naturally acquired immune responses against novel pre-erythrocytic Plasmodium vivax proteins in a low endemic malaria population located in the Peruvian Amazon Basin

BackgroundPlasmodium vivax represents the most geographically widespread human malaria parasite affecting civilian and military populations in endemic areas. Targeting the pre-erythrocytic (PE) stage of the parasite life cycle is especially appealing for developing P. vivax vaccines as it would prevent disease and transmission. Here, naturally acquired immunity to a panel of P. vivax PE antigens was explored, which may facilitate vaccine development and lead to a better understanding of naturally acquired PE immunity.MethodsTwelve P. vivax PE antigens orthologous to a panel of P. falciparum antigens previously identified as highly immunogenic in protected subjects after immunization with radiation attenuated sporozoites (RAS) were used for evaluation of humoral and cellular immunity by ELISA and IFN-γ ELISpot. Samples from P. vivax infected individuals (n = 76) from a low endemic malaria region in the Peruvian Amazon Basin were used.ResultsIn those clinical samples, all PE antigens evaluated showed positive IgG antibody reactivity with a variable prevalence of 58–99% in recently P. vivax diagnosed patients. The magnitude of the IgG antibody response against PE antigens was lower compared with blood stage antigens MSP1 and DBP-II, although antibody levels persisted better for PE antigens (average decrease of 6% for PE antigens and 43% for MSP1, p < 0.05). Higher IgG antibodies was associated with one or more previous malaria episodes only for blood stage antigens (p < 0.001). High IgG responders across PE and blood stage antigens showed significantly lower parasitaemia compared to low IgG responders (median 1,921 vs 4,663 par/µl, p < 0.05). In a subgroup of volunteers (n = 17),positive IFN-γ T cell response by ELISPOT was observed in 35% vs 9–35% against blood stage MSP1 and PE antigens, respectively, but no correlation with IgG responses.ConclusionsThese results demonstrate clear humoral and T cell responses against P. vivax PE antigens in individuals naturally infected with P. vivax. These data identify novel attractive PE antigens suitable for use in the potential development and selection of new malaria vaccine candidates which can be used as a part of malaria prevention strategies in civilian and military populations living in P. vivax endemic areas.

Evaluation of full blood count among plasmodium parasatized pregnant women, in general hospital Sabo Kaduna state, Nigeria

Background: Malaria poses a significant public health challenge in sub-Saharan Africa, particularly among pregnant women, where it contributes to a high burden of infection and mortality. This study aimed to investigate the impact of malaria on haematological and biochemical parameters among pregnant women attending the Antenatal Clinic at General Hospital Sabo Kaduna State, North-Western Nigeria. Methodology: A total of 70 pregnant women participated in the study, with subjects aged between 15 and 40 years. A total of 70 pregnant women participated in the study, 50 of which were malaria positive and 20 of which were malaria negative. Participants were recruited from Antenatal Clinic of General Hospital Sabo, Kaduna State. Socio-demographic characteristic and blood samples were collected and examine for malaria parasite, some haematological parameters (HCT, HGB, WBC, RBC and platelet count) were measured using the sysmex auto-haematology analyzer. Data generated was analyzed using SPSS 22.0 statistical package. Results: Findings revealed that younger women, particularly those aged 21-25 years, constituted a significant proportion of the subjects, consistent with previous reports. Haematological analysis demonstrated a significant decrease in haematocrit (HCT), haemoglobin (HGB), red blood cell count (RBC), and platelet count among malaria parasitized pregnant women compared to controls (p&lt;0.05). However, white blood cell (WBC) count remained within the normal reference range for both groups. Conclusion: These findings corroborate previous research indicating that malaria infection leads to alterations in haematological parameters, primarily attributed to mechanical destruction of parasitized red blood cells and splenic clearance. Furthermore, there should be an enhanced efforts to implement malaria prevention and control strategies, promote sanitation practices to reduce mosquito breeding sites, and prioritize the inclusion of malaria parasite investigation as a routine test in antenatal care for pregnant women.

Distribution of Parasitic Infections among Pupils in Kwara State, Nigeria

Background: Parasitic infections pose a significant health burden among school-age children in Nigeria. Aim and Objective: This study aimed to investigate the distribution of parasitic infections among pupils in Kwara State, Nigeria. Materials and Methods: A total of 638 pupils from various primary schools in Kwara Central, Kwara South, and Kwara North senatorial districts were included in the study. Stool, blood, and urine samples were collected from each participant, and appropriate preservation methods were employed. Parasite identification was carried out using microscopy, staining techniques, and concentration methods described in previous studies. Results: The results revealed an overall prevalence of 19.4% among the pupils, with 80.6% found to be uninfected. The most common parasitic infections were Ascaris lumbricoides (55.6%), Schistosoma mansoni (11.2%), Plasmodium (10.5%), Entamoeba histolytica (8.9%), Hookworm (8.1%), Fasciola gigantica (4.0%), and Schistosoma haematobium (1.6%). Further analysis focused on the age distribution of parasitic infections. Among pupils aged 1–5 years, Plasmodium infection had a prevalence of 23.1%. In the 6–10 years age group, A. lumbricoides (59.4%), S. mansoni (74%), E. histolytica (45.5%), Hookworm (30.0%), F. gigantica (20%), and Plasmodium (61.5%) were prevalent. Among pupils aged 11–15 years, A. lumbricoides (40.6%), S. mansoni (28.6%), E. histolytica (54.5%), Hookworm (70.0%), F. gigantica (60.0%), Plasmodium (15.4%), and S. haematobium (1.6%) were observed. Pupils aged 16–20 years showed a lower prevalence of parasitic infections, with F. gigantica (20%) being the only detected parasite. Conclusion: The findings highlight the varying distribution of parasitic infections among different age groups, emphasizing the need for age-specific interventions. The high prevalence of certain parasites, such as A. lumbricoides, S. mansoni, and Plasmodium, indicates the importance of implementing targeted deworming programs, improved sanitation, hygiene practices, and malaria prevention strategies. These measures can effectively reduce the burden of parasitic infections and promote the health and well-being of pupils in Kwara State, Nigeria.

Enhancing IPTp Program Implementation: Provider Practices, Challenges, and Malaria Prevalence among Pregnant Women in Uganda

Malaria remains a formidable public health threat, particularly in sub-Saharan Africa, where pregnant women face heightened vulnerability. Intermittent Preventive Treatment in pregnancy with Sulfadoxine Pyrimethamine (IPTp-SP) stands as a pivotal strategy in malaria prevention efforts. However, its full potential is hindered by challenges in implementation. This study, conducted at Bushenyi Health Centre IV in Uganda, scrutinized provider practices, challenges encountered, and malaria prevalence among pregnant women attending antenatal care services. Through a descriptive cross-sectional approach involving 151 pregnant mothers and 15 antenatal care providers, analysis revealed noteworthy insights. While a majority of pregnant women received IPTp-SP, adherence to WHO guidelines regarding administration timing and frequency was suboptimal. Notably, over half of the providers reported stockouts of IPTp-SP, leading to significant delays in replenishment and impeding service delivery. Moreover, providers identified a crucial link between women's knowledge and IPTp uptake. The study also uncovered a malaria prevalence of 7.9% among pregnant women. These findings underscore the urgent need to address implementation challenges, particularly in supply chain management and health education, to fortify malaria prevention strategies for pregnant women in Uganda. Keywords: Malaria, Pregnant women, IPTp-SP, Antenatal care, Implementation challenges, Supply chain management, Health education, Uganda.

Utilization of malaria preventive strategies among pregnant women at Adeoyo Maternity Teaching Hospital, Ibadan, Nigeria

INTRODUCTION: Malaria in pregnancy is associated with a high rate of maternal and perinatal morbidity and mortality. Utilization of preventive strategies during pregnancy is an integral part of controlling the burden of malaria in pregnancy. This study evaluated the malaria preventive strategies utilized and the prevalence of asymptomatic malaria among pregnant women at Adeoyo Maternity Teaching Hospital (AMTH), Ibadan, Nigeria.&#x0D; METHODS: A facility-based descriptive cross-sectional study among 223 pregnant women in Adeoyo Maternity Teaching Hospital, Ibadan, Nigeria. Information on socio-demographic and obstetric characteristics, malaria symptoms, and the preventive strategies utilized were obtained using a structured questionnaire. Descriptive and bivariate analysis using chi-square test and multivariate analysis at 95% confidence interval and p&lt; 0.05 was used to determine the predictors of asymptomatic malaria infection in relation to socio-demographic characteristics and malaria preventive strategies utilized.&#x0D; RESULTS: The mean age was 30±5 years. More than half (53.4%) of them used insecticide-treated nets consistently, 49.3% sprayed the room regularly with insecticides, while the majority (88.3%) reported they maintained a clean environment. However, 11.7% tested positive for the malaria parasite. Consistency in the use of insecticide-treated net (ITN) and participants age were factors associated with malaria occurrence (p=0.01). The use of ITN and being &gt;30 years of age are protective factors against having malaria infection among pregnant women (AOR= 0.34; 95%, CI=0.14-0.84) and (AOR=0.31; 95% CI=0.13-0.76) respectively.&#x0D; CONCLUSION: Irrespective of all other malaria preventive strategies adopted by pregnant women, consistent use of ITN was independently a protective factor against developing malaria in pregnancy.

Demographic and socio-economic factors affecting bed net ownership, usage, and malaria transmission among adult patients seeking healthcare in two Ghanaian urban cities

BackgroundThe most cost-effective malaria prevention and control strategy is the use of a bed net. However, several factors affect the ownership and usage of bed nets among the adult population. Hence, this study aimed to examine socio-demographic factors affecting bed net ownership, usage and malaria transmission among adult patients seeking healthcare in two Ghanaian urban cities.MethodsThis hospital-based cross-sectional study was conducted, between January and September 2021, at Bremang Seventh-Day Adventist Hospital, Suame Municipal, Ashanti Region and Sunyani Municipal Hospital, Sunyani, Bono Region, Ghana. Structured questionnaires were administered to a total of 550 participants to ascertain their ownership and usage of the bed nets. Afterwards, finger prick blood samples were collected for malaria microscopy. Crude and adjusted prevalence ratios (PR) and their respective 95% CIs were calculated, using Poisson regression with robust standard errors, to show associated variables in bivariate and multivariate analyses respectively. R software (version 4.1.1) was used to perform all statistical analyses.ResultsAbout 53.3% (n = 293) of participants owned at least one-bed net but only 21.5% (n = 118) slept under it the previous night. Those married were 2.0 (95% CI: 1.6 – 2.5) and 2.4 (95% CI: 1.6 – 3.5) times more likely to own and use a bed net respectively than those who never married. Also, pregnant women were 1.3 (95% CI: 1.1 – 1.6) and 1.8 (95% CI: 1.3 – 2.5) times more likely to own and use a bed net respectively than non-pregnant. Even though income levels were not associated with bed net ownership and usage, students were 0.4 (95% CI: 0.2 – 0.6) and 0.2 (95% CI: 0.1 – 0.5) times less likely to own and use bed net respectively compared to formally employed persons. The overall malaria prevalence rate was 7.8%. Malaria-negative patients were 1.6 (95% CI: 1.2 – 2.0) and 2.4 (95% CI: 1.4 – 4.1) times more likely to own and use bed nets respectively than malaria positive. Patients with tertiary education recorded the lowest malaria prevalence (3.5%, n = 4). None of those with a monthly income > $300 recorded a case of malaria. On the contrary, majority 83%, n/N = 25/30) of the malaria-positive patients earned ≤ $150.ConclusionThe National Malaria Control Program should conduct comprehensive mapping of all urban population segments before launching mass bed net distribution campaigns, taking into account demographic and socioeconomic factors to enhance bed net utilization and reduce malaria prevalence.

Knowledge, attitude and practices on intermittent preventive treatment in pregnant women with malaria: a mixed method facility-based study in Western Kenya.

intermittent preventive treatment remains a core strategy for malaria prevention in pregnancy. Sulfadoxine-pyrimethamine is recommended for all pregnant women in malaria-prone zones. It is scheduled monthly at each antenatal care visit for up to 36 weeks. Here, we sought to assess the knowledge, attitude, and practices of intermittent preventive treatment among pregnant women with malaria in Webuye Hospital. a total of 140 participants aged between 18 and 49 years and at approximately 16 weeks of gestation were enrolled in this study, which utilized a mixed qualitative-quantitative method. Before enrollment, malaria testing was conducted using microscopy, and participants were divided into two cohorts: malaria-positive and malaria-negative. Close-ended and open-ended questionnaires were used. Qualitative-quantitative data analyses were performed. our analysis revealed a significant difference between the proportion of mothers in the negative and positive groups in terms of their knowledge about side effects (p ≤ 0.001) and different doses (p ≤ 0.012) of intermittent preventive treatment. The proportion of mothers who knew side effects and different doses was higher among the malaria-positive group as compared to malaria-negative group with 37(52.9%, n=70) versus 18(25.7%, n=70) and 14(20.0%, n=70) versus 4(5.7%, n=70) respectively. Additionally, there was also a significant difference in knowledge about intermittent preventive treatment before administration (p ≤ 0.003) between the two groups. good knowledge, attitude and practices on intermittent preventive treatment (IPT) benefits, side effects, safety, doses and other prior information should be leveraged to empower pregnant women in malaria-endemic zones.

Malaria prevalence and associated factors among symptomatic children aged under five years attending Sheko District Health Center, Southwest Ethiopia: A cross-sectional study.

Malaria is a major cause of morbidity and mortality in children under the age of five worldwide. Although various malaria elimination measures have been implemented over the past decades, malaria remains a serious threat to public health, especially in tropical and subtropical areas. Ethiopia has set targets for eliminating malaria by 2030. No research has been conducted in the study area concerning malaria among children, who are the most malaria-prone segment of a community. The purpose of this study was to assess malaria prevalence and the factors associated with it among children under five years of age who attended the Sheko Health Center, Southwest Ethiopia, from June 1 to October 30, 2022. An institutional-based cross-sectional study was employed from June 1 to October 30, 2022, at the Sheko Health Center. Capillary blood samples were collected from 286 randomly selected symptomatic children. Data on socio-demographics and associated factors were collected using a pre-tested structured questionnaire, and data on parents' and guardians' knowledge about malaria was recorded on Excel 2016 Spreadsheets after interviewing them, and their responses were presented by a frequency table. Data were entered into Epi Data Manager (v4.0.2.101) and analyzed using the Statistical Package for Social Sciences (SPSS) version 25. Associated factors of malaria were analyzed using bivariate and multivariable logistic regression, and statistical significance was set at P < 0.05. Overall, 23.4% (95% CI = 18.6-28.8%) malaria infection was recorded among the children whose blood samples were examined, with Plasmodium falciparum, Plasmodium vivax, and mixed infections (both species) representing 52.2%, 34.3%, and 13.4% of the cases, respectively. The majority of the parents or guardians believed that malaria is transmissible but could be prevented, and 80% of them considered mosquito bites to be the main mode of malaria transmission. Insecticide-treated net (ITN) was mentioned as a malaria prevention strategy by more than half of the respondents, while indoor residual spraying (IRS) was considered only by 19.6%. Based on multivariable logistic regression analysis, a significant association was found in children between the ages of 12 and 36 months (adjusted odds ratio = 5.050; 95% CI: 1.964-12.982), children who lived in rural areas (adjusted odds ratio = 2.901; 95% CI: 1.439-5.845), and children who did not use ITN the past two weeks before sample collection (adjusted odds ratio = 3.341; 95% CI: 1.646-6.781). This study revealed a high malaria prevalence among children aged under five years. Attention must be paid to improving the coverage of the ITN and its use in the study area, which could help reduce the risk of mosquito bites. Health education for the guardians of the children could also help to raise awareness about the prevention and control strategies for malaria transmission and further reduce the impact of the disease.

In-silico analysis of potent Mosquirix vaccine adjuvant leads

BackgroundWorld Health Organization recommend the use of malaria vaccine, Mosquirix, as a malaria prevention strategy. However, Mosquirix has failed to reduce the global burden of malaria because of its inefficacy. The Mosquirix vaccine’s modest effectiveness against malaria, 36% among kids aged 5 to 17 months who need at least four doses, fails to aid malaria eradication. Therefore, highly effective and efficacious malaria vaccines are required. The well-characterized P. falciparum circumsporozoite surface protein can be used to discover adjuvants that can increase the efficacy of Mosquirix. Therefore, the study sought to undertake an in-silico discovery of Plasmodium falciparum circumsporozoite surface protein inhibitors with pharmacological properties on Mosquirix using hierarchical virtual screening and molecular dynamics simulation. ResultsMonoclonal antibody L9, an anti-Plasmodium falciparum circumsporozoite surface protein molecule, was used to identify Plasmodium falciparum circumsporozoite surface protein inhibitors with pharmacological properties on Mosquirix during a virtual screening process in ZINCPHARMER that yielded 23 hits. After drug-likeness and absorption, distribution, metabolism, excretion, and toxicity property analysis in the SwissADME web server, only 9 of the 23 hits satisfied the requirements. The 9 compounds were docked with Plasmodium falciparum circumsporozoite surface protein using the PyRx software to understand their interactions. ZINC25374360 (−8.1 kcal/mol), ZINC40144754 (−8.3 kcal/mol), and ZINC71996727 (−8.9 kcal/mol) bound strongly to Plasmodium falciparum circumsporozoite surface protein with binding affinities of less than −8.0 kcal/mol. The stability of these molecularly docked Plasmodium falciparum circumsporozoite surface protein-inhibitor complexes were assessed through molecular dynamics simulation using GROMACS 2022. ZINC25374360 and ZINC71996727 formed stable complexes with Plasmodium falciparum circumsporozoite surface protein. They were subjected to in vitro validation for their inhibitory potential. The IC50 values ranging between 250 and 350 ng/ml suggest inhibition of parasite development. ConclusionTherefore, the two Plasmodium falciparum circumsporozoite surface protein inhibitors can be used as vaccine adjuvants to increase the efficacy of the existing Mosquirix vaccine. Nevertheless, additional in vivo tests, structural optimization studies, and homogenization analysis are essential to determine the anti-plasmodial action of these adjuvants in humans.

Disentangling the intersection of inequities with health and malaria exposure: key lessons from rural communities in Northern Borneo

BackgroundThe increasing incidence of Plasmodium knowlesi malaria poses a significant challenge to efforts to eliminate malaria from Malaysia. Macaque reservoirs, outdoors-biting mosquitoes, human activities, and agricultural work are key factors associated with the transmission of this zoonotic pathogen. However, gaps in knowledge regarding reasons that drive malaria persistence in rural Kudat, Sabah, Northern Borneo remain. This study was conducted to address this knowledge gap, to better understand the complexities of these entangled problems, and to initiate discussion regarding new countermeasures to address them. This study aims to highlight rural community members’ perspectives regarding inequities to health relating to P. knowlesi malaria exposure.MethodsFrom January to October 2022, a study using qualitative methods was conducted in four rural villages in Kudat district of Sabah, Malaysia. A total of nine in-depth interviews were conducted with community and faith leaders, after the completion of twelve focus group discussions with 26 photovoice participants. The interviews were conducted using the Sabah Malay dialect, audio-recorded, transcribed, and translated into English. The research team led the discussion and analysis, which was approved by participants through member checking at the community level.ResultsParticipants identified disparity in health as a key issue affecting their health and livelihoods. Injustice in the social environment was also identified as a significant challenge, including the importance of listening to the voices of affected communities in disentangling the social and economic phenomena that can impact malaria control. Specific concerns included inadequate access to health-related resources and degradation of the environment. Participants recommended improving access to water and other necessities, increasing the availability of malaria control commodities in healthcare facilities, and developing sustainable programs to reduce socioeconomic disparities.ConclusionInequities to health emerged as a key concern for malaria control in rural Kudat, Sabah. A locally targeted malaria programme cantered on improving the social and economic disparities associated with health outcomes, could be a potential strategy for malaria prevention in such areas. Community-level perspectives gathered from this study can be used as a foundation for future discussions and dialogues among policymakers and community members for achieving greater transparency, improving social equity, and interoperability in addressing P. knowlesi malaria control.

House-wall modification after indoor residual spraying in Shashogo district, southern Ethiopia

BackgroundIndoor residual spraying has been a key national malaria prevention and control strategy in Ethiopia. However, there is a gap in monitoring and evaluation of house-wall modification after indoor residual spraying before the end of residual lifespan. This study has determined the prevalence of house-wall modification after indoor residual spraying and identified the associated factors in Shashogo district, southern Ethiopia.MethodsA community-based cross-sectional study was conducted from April to May 2022. Data were collected from 640 randomly selected households using a pre-tested questionnaire and an observational checklist. The binary logistic regression models were used to identify factors associated with house-wall modification after indoor residual spraying before the end of the potency period.ResultsThe prevalence of house-wall modification after indoor residual spraying was found to be 30.4% (95% CI 27.4–34.2%). Educational status of could not read and write [AOR = 1.76, 95% CI (1.16, 2.68)], monthly income of more than birr 3000 [AOR = 3.27, 95% CI (1.78, 6.01)], low level of knowledge about indoor residual spraying [AOR = 3.81, 95% CI (2.39, 6.06)], lack of information within two weeks before spraying [AOR = 2.23, 95% CI (1.44, 3.46)], absence of supervision after spraying [AOR = 1.79, 95% CI (1.14, 2.81)], absence of stagnant water near house [AOR = 3.36, 95% CI (2.13, 5.39)], and thatched roof [AOR = 1.82, 95% CI (1.04, 3.16)] were factors significantly associated with house-wall modification after indoor residual spraying.ConclusionThis study has revealed that the prevalence of house-wall modification after indoor residual spraying before the end of the residual lifespan in the study area was higher compared to other studies in developing countries. Therefore, special emphasis should be given to providing community education about indoor residual spraying, conducting regular supervision before and after residual spraying, enforcing some legislative strategies for modifying the house-wall before six months after spraying, and improving environmental and housing conditions.